Definition
- Pain or discomfort located between the bottom of the rib cage and the groin crease
- The older child complains of a stomachache
- The younger child should at least point to or hold the abdomen
Causes
- Indigestion: Indigestion or overeating causes many mild stomachaches
- Gastroenteritis: A viral infection of the intestines causes stomach cramps as well as vomiting and/or diarrhea
- Food Poisoning: Severe vomiting and/or diarrhea lasting less than 12 hours is often due to bacterial overgrowth in unrefrigerated foods
- Constipation: The need to pass a BM causes lower abdominal cramps
- Strep: A strep throat causes up to 10% of acute abdominal pain
- Serious Causes: These include appendicitis, kidney infections and intussusception
When to Call Your Doctor for Abdominal Pain
Call 911 If…
- Your child is not moving or too weak to stand
Call Your Doctor Now (night or day) If
- Your child looks or acts very sick
- You suspect poisoning with a plant, medicine, or chemical
- Unable to walk or walks bent over holding the abdomen
- Pain mainly low on the right side
- Pain or swelling in the scrotum or testicle (Male)
- Could be pregnant (Female)
- Severe pain anywhere
- Constant pain (or crying) present over 2 hours
- Blood in the bowel movements or vomiting blood
- Vomiting bile (bright yellow or green)
- Recent injury to the abdomen
- Age under 2 years
- Fever over 104° F (40° C) and not improved 2 hours after fever medicine
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
- Mild pain that comes and goes (cramps) lasts over 24 hours
Call Your Doctor During Weekday Office Hours If
- You have other questions or concerns
- Abdominal pains are a recurrent chronic problem
Parent Care at Home If
- Mild abdominal pain and you don't think your child needs to be seen
Home Care Advice for Mild Abdominal Pain
- Reassurance:
- A mild stomachache can be caused by something as simple as gas pains or overeating.
- Sometimes a stomachache signals the onset of a vomiting or diarrhea illness from a virus (gastroenteritis).
- Watching your child for 2 hours will usually tell you the cause.
- Rest: Encourage your child to lie down and rest until feeling better.
- Clear Fluids: Offer clear fluids only (e.g., water, flat soft drinks or half-strength Gatorade). For mild pain, offer a regular diet.
- Prepare for Vomiting: Keep a vomiting pan handy. Younger children often refer to nausea as a "stomachache".
- Pass a BM: Encourage sitting on the toilet and trying to pass a bowel movement (BM). This may relieve pain if it is due to constipation or impending diarrhea. (Note: for constipation, sitting in warm water may relax the anus and help release a BM)
- Avoid Medicines: Any drug (especially ibuprofen) could irritate the stomach lining and make the pain worse. Do not give any pain medicines or laxatives for stomach cramps. For fever over 102° F (39° C), acetaminophen (Tylenol) can be given.
- Expected Course: With harmless causes, the pain is usually better or resolved in 2 hours. With gastroenteritis (stomach flu), belly cramps may precede each bout of vomiting or diarrhea and last several days. With serious causes (such as appendicitis), the pain worsens and becomes constant.
- Call Your Doctor If:
- Pain becomes severe
- Constant pain present over 2 hours
- Mild pain that comes and goes present over 24 hours
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 1/19/2009
Last Revised: 6/12/2008
Copyright 1994-2009 Barton D. Schmitt, M.D.